Common Terms

Common Terms
The words we use every day can get to be confusing as we travel from place to place. There may be different ways of referring to the same thing.

For example, a cookie in Canada is a biscuit in Britain.

Differences exist in the terms that we use to refer to health care providers in primary care and public health across Canada.

For example, a Medical Officer of Health in Ontario is a Medical Health Officer in British Columbia. Public health nurses are also referred to as community health nurses depending on the province or territory. A health promoter might also be called a community development officer. This list goes on!

Terms in this Toolkit

In this module we used the definition from the Public Health Agency of Canada for collaboration:

Collaboration
Collaboration is a recognized relationship among different sectors or groups, which is formed to take action on an issue in a way that is more effective or sustainable than might be achieved by the public health sector acting alone. (Public Health Agency of Canada. (2007). Core Competencies for Public Health in Canada. Release 1.0, 1-25.)

Primary care is considered one of primary healthcare’s core services. We used Barbara Starfield’s definition of primary care in this module. She defines the key features of primary care as being:

Primary Care
“The first point entry to a health care system; the provider of person-focused (not disease-oriented) care over time; the deliverer of care for all but the most uncommon conditions; and the part of the system that integrates or co-ordinates care provided elsewhere or by others.” (Starfield B. Primary care: balancing health needs, services, and technology. New York: Oxford University Press; 1998.)

Public health is considered one of primary healthcare’s core services. As per the Public Health Agency of Canada, we defined public health as:

Public Health
“… an organized activity of society to promote, protect, and improve, and when necessary, restore the health of individuals, specified groups, or the entire population. It is a combination of sciences, skills, and values that function through collective societal activities and involve programs, services, and institutions aimed at protecting and improving the health of all people.

The term ‘public health’ can describe a concept, a social institution, a set of scientific and professional disciplines and technologies, and a form of practice. It is a way of thinking, a set of disciplines, an institution of society, and a manner of practice. It has increasing number and variety of specialized domains and demands of its practitioners [and] increasing array of skills and expertise.” (Public Health Agency of Canada. Core competencies for public health in Canada: Release 1.0. website [ 2007 [cited 2008 May 5]; Publication link: p.13)

Terms for Providers

Medical Officer of Health = Medical Health Officer

Community Health Nurse = Public Health Nurse

Health Promoter = Community Development Officer

Family Practice Nurse = Primary Care Nurse

Recognizing that there are many titles for different types of healthcare providers, we will use the following terms throughout the toolkit for some consistency.

Terms used in this Toolkit

Administrative support

Consultant / Specialist

Community Health Representative

Dental Hygienist

Dental Assistants

Environmental Health Officer

Epidemiologists

Evaluation / Research Officer

Family Physician

Health Promoter

Lay / Outreach Workers

Licensed Practical Nurse

Management / Manager

Medical Officer

Nutritionist / Dietitian

Primary Care Nurse

Program Consultants

Public Health Inspector

Public Health Nurse

Social Worker

Supervisor

More terms
To further add to the confusion, the organization of public health services in the provinces and territories also differs.

In most regions, public health is delivered through regional health authorities or the provincial/territorial government. Public health services in some cases are integrated into regional systems such as health authorities in British Columbia and Nova Scotia. In Ontario, public health services are delivered through independent health units.

In Quebec
Public health is delivered at the front line in local community service centres or LCSCs, where primary care and health promotion, and prevention programs and services are delivered. The main public health stakeholders are the Ministère de la Santé et des Services sociaux; the Institut national de santé publique du Québec (INSPQ); local health and social services network development agencies, particularly their public health branches; as well as health and social services centres (CSSS). The Chart of the Organization of the Health Services in Quebec is available from http://www.cssspnql.com/docs/centre-de-documentation/provincial-health-services.pdf?sfvrsn=2.

In the toolkit, we refer to a public health department or public health in general, and to a health authority or health authorities. Translation may depend on location context.

Public Health in Canada
The confusion continues! Primary care is also organized in different ways across the country.

Primary care is generally delivered by family physicians, although some primary care clinics are led by nurse-practitioners. Other primary care services are run by public health such as sexually transmitted infection (STI) clinics, or through outreach services.

As of 2007, 23% of family physicians were in solo practice, and 74% were in group or interprofessional practice in Canada. About half of physicians derive 90% of their income from a fee for service payment model. The rest generally are paid through a variety of mixed payment models. (Hutchison, B., Levesque, J.F., Srumpf, E. and Coyle, N., 2011)

Research has found that the makeup of primary care teams, who leads them, and models of reimbursement in primary care can influence collaboration success.

It is important to understand the primary care and public health system within a region specific context in order to build successful collaborations

Primary Care in Canada
The goal of this toolkit is not to highlight or describe all the differences in health care delivery structures and processes. However, we have incorporated examples of collaborations from various regions of Canada in an attempt to acknowledge this variability. As Toolkit2Collaborate is a Canadian product, we endeavoured to use Canadian English/QuébécoisFrench languages.

Managing Differences The toolkit is not meant to provide an exhaustive list of examples as this would warrant an entire toolkit for this topic alone and the structures are continuously changing. However, it will present the factors that can influence collaborations.